Throughout this season of MCHwork, we have looked at the Hexagon Tool as a way of determining the effectiveness of programs and policies in addressing some of the pressing needs for our MCH populations. This issue of MCHwork teases out how Systems Integration tools – specifically Human Centered Design, Causal Loop Diagramming, and System Support Mapping – augment the Hexagon Tool in this process.
What is Human Centered Design (HCD)? HCD is a problem-solving methodology that prioritizes user needs throughout the design process. By considering individual perspectives and employing iterative testing, HCD aims to create solutions that are not only functional but also resonate with populations of focus. HCD goes beyond simply considering user needs. It's an iterative process that revolves around understanding people, their contexts, and the challenges they face. HCD practitioners employ a variety of qualitative research methods, like user interviews and observations, to build empathy and gain a deep understanding of problems. This informs the brainstorming and prototyping of solutions, which are then rigorously tested with real users. This feedback loop allows for ongoing refinement until a program or practice is created that is truly user-centered and effective.1 In public health, HCD can be used to develop educational materials that are culturally responsive and easy to understand for diverse communities.2 This user-centric approach can be applied to any program or practice, ensuring that decisions are grounded in the lived experiences and preferences of the populations most impacted.
Why is HCD Important? HCD is the foundation. It involves user research (the community in this case) to understand their experiences, needs, and perspectives regarding health concerns. Through interviews, focus groups, and observations, HCD identifies the most pressing public health issues impacting the community.
Watch this video to learn how a human-centered design perspective can bolster the Hexagon Tool to center decisions about new programs or practices in the experiences and preferences of the populations you serve.
What is Causal Loop Diagramming (CLD)? CLD is a visual tool used to map out the cause-and-effect relationships between different factors within a system.3 By employing boxes and arrows, CLDs depict how changes in one variable can influence, and be influenced by, other variables over time.4 In our MCH communities, a CLD might illustrate how increased access to healthy foods (variable) can lead to better dietary choices (variable), which in turn can reduce obesity rates (variable) and healthcare costs (variable), ultimately prompting further investment in healthy food initiatives (variable). This focus on interconnectedness allows CLDs to be instrumental in designing interventions that consider the perspectives of various populations. By incorporating the potential impacts on different groups within the CLD, decision-makers can ensure new programs or practices address the specific needs and preferences of each population.
Why is CLD Important? Once a key issue is identified (e.g., high childhood obesity rates), CLD comes into play. This tool visually depicts the cause-and-effect relationships between factors contributing to the issue. Using arrows, CLDs show how factors like limited access to healthy food options (cause) can lead to higher obesity rates (effect). This helps identify the root causes for targeted intervention.
Watch this video about how a Causal-Loop Diagramming can combine with the Hexagon Tool to choose among options for a new program or policy.
What is System Support Mapping (SSM)? SSM is a tool used to understand the needs and resources of individuals within a complex system. It typically involves identifying an individual's role, responsibilities, the needs they have to fulfill those responsibilities, the resources available to them, and their needs for additional support.5 System support mapping can be to reveal gaps in resources or identify areas where workflows can be improved to better support professionals in their work. Ultimately, system support mapping allows decision-makers to consider the perspectives of different stakeholders, like healthcare workers and families, when developing new programs or practices, ensuring they are designed to address the actual needs and preferences of MCH populations.6
Why is SSM Important? Now that the root causes are clearer, system support mapping takes over. This tool focuses on existing resources and programs within the public health system. Following our example from above, it helps map out programs addressing healthy eating habits, nutrition education, or physical activity promotion within the community.
Watch this video about how system-support mapping can augment the Hexagon Tool to assess readiness for a new program or policy.
How Does the Hexagon Tool Fit In? With both the problem (identified by HCD and CLD) and existing programs (mapped by SSM) on the table, the Hexagon Tool steps in. The Hexagon Discussion and Analysis Tool is an evidence-based resource to learn about now so you can use it when you're ready to move from assessment to action. This tool allows you to explore various combinations of existing programs to find the most effective solution. The Hexagon Tool helps analyze how different program combinations (e.g., combining nutrition education with after-school sports programs) might address the identified public health issue (e.g., high childhood obesity).
References